About twenty-five species of squill have been described. Red squill and white squill varieties are distinguished by herbalists. No essential difference exists in the medicinal properties of the two kinds. The bulb has been used mainly as a stimulant, expectorant and diuretic. The fresh bulb is slightly more active medicinally than the dried bulb, but it also contains a sticky acrid juice that can cause skin inflammations.

Squill seems to have cardiac effects similar to digoxin, although to a lesser degree, due to its poor absorption. Therefore, serious caution is indicated before its use.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Currently, there is insufficient available evidence to recommend for or against the use of squill for coronary artery disease. Additional study is needed.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

There is no proven safe or effective dose for squill. Traditionally, extracts, syrups, tinctures, and vinegar preparations have been taken by mouth. Squill has also been studied for its cardiovascular effects using 1 milligram of an intravenous (injected) dose of methylproscillaridin (a cardiac glycoside of squill). Injections should only be given under the supervision of a qualified healthcare professional.

Children (younger than 18 years):

There is no proven safe or effective dose for squill in children, and use is not recommended.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to squill (Urginea maritime).

Side Effects and Warnings

Due to its cardiac glycoside constituents, squill has similar adverse effects as digitalis (a drug that regulates the rate and strength of the heartbeat), including arrhythmia (abnormal heart rate) and atrioventricular block. Other common adverse effects include abdominal pains, vomiting, blood in the vomit, nausea, and seizures. Death has been reported. When rubbed on the skin, irritation, including skin eruption, may occur.

Recurrent fever, arthralgia (joint pain), myalgia (muscle pain), leukocytosis (high white blood cell count) and lymphopenia (loss of lymphocytes, a type of white blood cell), has occurred after ingestion of Venocuran®. Venocuran® was taken off of the market in 1975 and it is not clear whether it was the Urginea maritima or another constituent that caused the adverse effects.

Avoid using squill in patients with heart, stomach, or intestine problems, including second or third degree atrioventricular block, hypertrophic cardiomyopathy (enlarged heart), carotid sinus syndrome, ventricular tachycardia, thoracic aortic aneurysm, or Wolff-Parkinson-White syndrome. Also avoid in patients with low potassium or high calcium levels.

Pregnancy and Breastfeeding

Squill is not recommended for use in pregnant or breastfeeding women due to a lack of available scientific evidence. Squill may have abortifacient (abortion inducing) effects.

Squill (Urginea maritime) has shown toxic effects similar to cardiac glycoside toxicity. In theory, squill may have additive toxic effects when used with cardiac glycosides, such as digoxin or digitoxin.

Concomitant use with corticosteroids (steroids) may increase effects and adverse effects of long-term corticosteroid use. Caution is advised.

When combined with quinidine (Quinidex®, Quinora®) or calcium, squill may increase the risk of cardiac toxicity and adverse effects. Laxatives and diuretics may deplete potassium and increase the risk of cardiac toxicity when taken with squill. Consult with a qualified healthcare professional, including a pharmacist, before combining therapies.

Interactions with Herbs and Dietary Supplements

Squill (Urginea maritime) has shown toxic effects similar to cardiac glycoside toxicity. In theory, squill may have additive toxic effects when used with cardiac glycosides, such as foxglove.

When combined with calcium, squill may increase the risk of cardiac toxicity and adverse effects. Laxatives, diuretics, and licorice all may deplete potassium and increase the risk of cardiac toxicity when taken with squill.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.